Sickle Cell Trait Reporting For

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HEIDELBERG UNIVERSITY

SICKLE CELL TRAIT REPORTING FORM

About Sickle Cell Trait:

Sickle cell trait is an inherited condition of the oxygen-carrying protein (hemoglobin) in the red blood cells.

Sickle cell trait is a common condition affecting over three million Americans.

Although sickle cell trait is predominant in African-Americans and those of Mediterranean,

Middle Eastern, Indian, Caribbean, and South and Central American ancestry, persons of all races and ancestry may test positive for sickle cell trait.

Sickle cell trait is usually benign, but during intense, sustained exercise, hypoxia (lack of oxygen) in the muscles may cause sickling of red blood cells (red blood cells changing from a normal disc shape to a crescent or “sickle” shape), which can accumulate in the blood stream and “log jam” blood vessels, leading to collapse from the rapid breakdown of muscles starved of blood.

Sickle Cell Trait Testing:

The NCAA mandates that all NCAA student-athletes have knowledge of their sickle cell trait status before the student-athlete participates in any intercollegiate athletics event, including strength and conditioning sessions, practices, competitions, etc.

Heidelberg University requires that all student-athletes must be tested for sickle cell trait, show proof of a prior test or sign a waiver releasing an institution from liability if they decline to be tested. Please see the NCAA’s website for further information or questions regarding the sickle cell trait. http://www.ncaa.org/gsearch/cell trait_testing

Initial one of the following options and sign below:

_____

I know my sickle cell trait status from previous medical testing, and have attached documentation to this form.

______ I do not know my sickle cell trait from previous medical testing, and would like to be tested when I arrive at Heidelberg University.

______I do not have previous medical documentation and choose not to undergo sickle cell trait testing. I hereby assume the risk of declining such a test and release Heidelberg University and its officers, employees and agents from any and all liability in connection with my participation in college athletics after declining the test.

__________________________________________________________________

(Signature of Student) (Date)

__________________________________________________________________________________________________________________

(Signature of parent/guardian if athlete is under 18 years of age) (Date)

***Note: If you were born in the State of Ohio, your sickle cell test was completed as a newborn infant and you do not need to be re-tested.

Your parents were only notified at the time of your birth if the test results were positive for the sickle cell trait.

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